Ask The Book Doctor!

This week’s questions come from recent headlines and stories in the news.

Remember, if you’re a writer or a fan of books, TV shows, or movies–or even a news junkie–and have a medical-themed question you’d like to see answered in this weekly column, check out the submission guidelines at the bottom!

Photo Credit: Fesenberg5000

Q. As the mother of active and thirsty preschooler, I was frightened to hear about recent reports that apple juice—one of the most popular choice of juices for young children—contains arsenic. What impact will this have on my child who has consumed apple juice regularly for years? Melanie J.

A. Arsenic is in a group of toxic materials that we call “heavy metals.” It can cause both nerve and brain damage. The nerve damage is often reversible. It is a curious fact that bottled water is given much less testing than city water despite selling at a premium! Similarly, although certain impurities are checked in juice, not everything can be.

A hundred years ago, before the development of other antibiotics, arsenic was used to treat syphilis and was generally effective. So obviously, at some level, it does no grave damage.

Unless your child is showing signs of learning or other problems, I would not be overly concerned. That said, I’d avoid the apple juice until this issue is sorted out.

Photo Credit: Healing Resources

Q. I recently read about a young man rendered brain dead after an overdose of pain killers who was later given to moments of awareness upon being administered the insomnia drug, Ambien. How is this possible? Wouldn’t a drug like this, used to induce sleep, have the opposite effect? Stephen R.

A. In neurology, we have to be open minded (no pun intended!). The brain is the most complex organ in the body by far. Not designed by man, its function is still more mystery than it is known fact. Neurons don’t synapse (connect) to other neurons physically; rather, they stop just short of touching. They “talk” to each other by discharging a neurotransmitter (chemical) that then causes a reaction in the second neuron. There are a number of these chemicals that we know about, but almost certainly more that we don’t. In this case, and perhaps 10% of what is called “minimally conscious” or vegetative, improvement will be seen. On rare occasions, it can be dramatic.

We don’t know how this happens, but it is, at times, how progress is made in medicine. Ambien (zolpidem) affects the part of the brain that modulates sleep and wakefulness. With damaged connections, then are many possibilities as to why it might work. The original case was actually misprescribed. But remember—penicillin resulted from a botched experiment too.

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Attention writers and readers! If you need quick insight/advice on a medical condition that affects a character or impacts a storyline, or curious about a medical story in the news, please email your question to fritz@fritzstrobl.net. I’ll post two answers here every week!

Due the volume of requests received, I am unable to provide personal responses. Questions should pertain to characters or stories you’re writing, books you’re reading, TV shows/movies you’re watching, or health issues in the news. If you have a question about a personal health issue, please contact your doctor.

Ask The Book Doctor!

If you’re a writer or a fan of books, TV shows, or movies and have a medical-themed question you’d like to see answered in this weekly column, check out the submission guidelines at the bottom!

Q. I’m working on a novel and my main character is a middle-aged police detective who is diabetic. Family members who are diabetic often complain about getting pains in their feet and I figure that since crafty detective work entails being on one’s feet, I’d like to know more about how to integrate these symptoms into my character’s life. Can you tell me more about what causes this type of foot pain and how it is alleviated? Karen B.

A. Diabetes is the single largest identifiable cause of peripheral neuropathy. Sufferers generally complain of numbness and burning because the nerve endings–usually in the feet–don’t work as well. Modernmedications for alleviating the pain include gabapentin and pregabalin. Your character would likely walk with his feet a bit further apart and be somewhat unstable in the dark because he would have trouble feeling his feet.

Q. As the holiday season is upon us, I’ve seen an overwhelming amount of information on TV and in magazines dedicated to gluten free cooking and products for those sensitive to wheat. I don’t recall this being a health issue over the last 30 years, but it suddenly seems like more and more people have wheat allergies today. What’s this all about? Jeffrey S.

A. Gluten sensitivity has been recognized only in recent times. Once thought to be interchangeable with celiac disease, a spectrum of diseases has been identified in which gluten sensitivity is a factor. In addition to the obvious gastrointestinal symptoms, there may be more distant effects, including some that are neurological. Estimates vary, but 5-10% of Americans may be affected. Why are we often allergic to food? We can create antibodies to anything, including to ourselves, such as in autoimmune disease. One theory is that the wheat we eat today is much different than the grain our ancestors consumed. So, although wheat may be nutritious and more productive per acre, it may not be without side effects.

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Attention writers! If you’re working on a book, script, or article and need quick insight or advice on a medical condition that affects a character or impacts a storyline, please email your question to fritz@fritzstrobl.net. I’ll post answers to two questions every Monday on this blog!

Due the volume of requests received, I am not able to provide personal responses. Questions should pertain to characters or stories you’re writing, books you’re reading, TV shows/movies you’re watching, or health issues in the news. If you have a question about a personal health issue, please contact your doctor.

The Book Doctor Is In

Today, I’m pleased to be launching a weekly column on this blog devoted to answering medical-related questions writers have been asking that pertain to characters or stories they are writing, books they are reading, or TV shows/movies they are watching. Since my medical background and cases inspire ideas for my own books, I would like to help other writers and readers understand more about common and unique medical maladies.

Q. I am writing a book that is set in 19th Century New England and my lead character suffers from insomnia and stress. From books I’ve read, it seems that doctors in that era frequently prescribed laudanum to alleviate these symptoms. Can you tell me more about this drug and its side effects? Vicky, NYC

A. Laudanum is also known as tincture of opium. It is 10% opium and 90% alcohol, usually with a flavoring added to mask its bitter taste. Obviously the 180 proof had an effect outside the opium. It was probably invented in the 16th century and its name comes from the Latin laudare, to praise. Laudanum has strong analgesic properties and was used for many purposes ranging from menstrual cramps to colic in babies. It was used recreationally as well. By the 19th century, laudanum was in popular use without a prescription. In addition to characters in novels, like Sherlock Holmes, it was used by authors themselves, among them Sir Arthur Conan Doyle, John Keats, Edgar Allen Poe, Lewis Carroll, and even Charles Dickens. Laudanum has side effects that are typical of most narcotics, such as dependence, withdrawal, sedation, constipation, and death (from overdose). In the 20th century it was removed from the over-the-counter market, along with the cocaine in Coca-Cola!

Q. I’m a big fan of the TV show, House. Almost every week, when Dr. House and his team of experts are trying to figure out their patient’s baffling medical condition, “amyloidosis” is often suggested as a possible diagnosis. What exactly is amyloidosis? Stuart, Jersey City, NJ

A. Amyloidosis is a rare disease caused by an abnormal protein called amyloid being produced in the bone marrow. Abnormal antibody proteins can create amyloid deposits that build up in the bloodstream and damage any organ. They frequently affect the heart, kidneys, and nervous system. There are various forms and because it is rare and difficult to diagnose, amyloidosis is generally incurable. Symptoms can range from changes in color/texture of skin, swelling in ankles and legs, numbness in hands or feet, fatigue, and shortness of breath–symptoms indicative of a variety of other illnesses. I check for it in my patients because it can cause peripheral neuropathy. Not thought to be contagious, one of my neurology professors, who studied it extensively, performed numerous biopsies on patients who died from it, actually (and sadly ironically) died from it himself! Those of us who do procedures always eventually stick or cut ourselves while treating patients. The movie Puncture deals with some of the dangers of modern medicine.

Attention writers! If you’re working on a book or script and need quick insight or advice on a medical condition that affects a character or impacts a storyline, please email your question to fritz@fritzstrobl.net. I’ll post answers to two questions every Monday on this blog!

Please note: due the volume of requests received, I am not able to provide personal responses, nor can I answer questions regarding personal health. If you have a question or concern about a health issue, please contact your doctor.